Open AccessRecurarization in a successfully managed case of posterior reversible encephalopathy syndrome (PRES) for emergency caesarean section
Author(s) -
Suchita Shailesh Parikh,
Snehlata Tavri,
Shubha N Mohite
Publication year - 2016
Publication title -
al-banǧ. maqālāt wa abḥāṯ fī al-taẖdīr wa-al-in’āš
Language(s) - English
Resource type - Journals
ISSN - 0259-1162
DOI - 10.4103/0259-1162.167833
Subject(s) - posterior reversible encephalopathy syndrome , medicine , eclampsia , anesthesia , encephalopathy , hyperintensity , neuroimaging , magnetic resonance imaging , pediatrics , surgery , pregnancy , radiology , biology , psychiatry , genetics
Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiologic syndrome of headache, visual changes, altered mental status and seizures with radiologic findings of posterior cerebral white matter edema. It is seen in hypertensive encephalopathy, renal failure, and autoimmune disorders or in patients on immunosuppressants. We report a case of 24-year-old primigravida who presented at term with sudden onset hypertension, neurological deficits, and an episode of the visual blackout. Magnetic resonance imaging showed features suggestive of PRES. She was posted for emergency lower segment cesarean section. General anesthesia was administered and blood pressure managed with antihypertensives. Postoperatively, she developed acute respiratory depression after prophylactic administration of injection magnesium sulfate. This case highlights that good clinical acumen along with early neuroimaging helps in prompt diagnosis, treatment and prevention of long-term neurological sequelae in PRES and the anesthetic implications of administering magnesium sulfate in the immediate post neuromuscular block reversal phase.